Changes of evening exposure to electronic devices during the COVID-19 lockdown affect the time course of sleep disturbances

  1. Federico Salfi
  2. Giulia Amicucci
  3. Domenico Corigliano
  4. Aurora D’Atri
  5. Lorenzo Viselli
  6. Daniela Tempesta
  7. Michele Ferrara

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Abstract

Study Objectives

During the coronavirus disease 2019 (COVID-19) lockdown, there was a worldwide increase in electronic devices’ daily usage. Prolonged exposure to backlit screens before sleep influences the circadian system leading to negative consequences on sleep health. We investigated the relationship between changes in evening screen exposure and the time course of sleep disturbances during the home confinement period due to COVID-19.

Methods

2,123 Italians (mean age ± standard deviation, 33.1 ± 11.6) were tested longitudinally during the third and the seventh week of lockdown. The web-based survey evaluated sleep quality and insomnia symptoms through the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. The second assessment survey inquired about intervening changes in backlit screen exposure in the two hours before falling asleep.

Results

Participants who increased electronic device usage showed decreased sleep quality, exacerbated insomnia symptoms, reduced sleep duration, prolonged sleep onset latency, and delayed bedtime and rising time. In this subgroup, the prevalence of poor sleepers and individuals reporting moderate/severe insomnia symptoms increased. Conversely, respondents reporting decreased screen exposure exhibited improved sleep quality and insomnia symptoms. In this subgroup, the prevalence of poor sleepers and moderate/severe insomniacs decreased. Respondents preserving screen time habits did not show variations of the sleep parameters.

Conclusions

Our investigation demonstrated a strong relationship between modifications of evening electronic device usage and time course of sleep disturbances during the lockdown period. Monitoring the potential impact of excessive evening exposure to backlit screens on sleep health is recommendable during the current period of restraining measures due to COVID-19.

Article activity feed

  1. Version published to 10.1093/sleep/zsab080
  2. ScreenIT

    SciScore for 10.1101/2020.10.20.20215756: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study has been approved by the institutional review board of the University of L’Aquila (protocol n. 43066) and has been carried out according to the principles established by the Declaration of Helsinki.
    Consent: Online informed consent to participate in the whole research was obtained from all the respondents during the first assessment.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations: To the best of our knowledge, the present investigation is the first to provide insights about the relationship between electronic device usage and the time course of sleep disturbances during the COVID-19 lockdown. However, it should be acknowledged that we used a non-probabilistic sampling technique, and the sample comprised a higher prevalence of women and young people. Moreover, under-eighteen years-old individuals were not included. However, the relationship between evening screen time and sleep disturbances was widely shown in adolescents.61–63 We hypothesize that our results could be generalizable to the youngest people. Additionally, the electronic device category of our survey included a broad set of devices, and we can not discern the relationship between each device usage and the time course of the sleep outcomes. Finally, in our survey, we did not assess the implementation of protective approaches to reduce the emission or perception of screen light, and thus we can not estimate their contribution to the present findings.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.10.20.20215756v1 on medRxiv